Provider Demographics
NPI:1003917402
Name:DA REITZ PEREIRA, CARLINDO (MD)
Entity Type:Individual
Prefix:
First Name:CARLINDO
Middle Name:
Last Name:DA REITZ PEREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 LITTLE MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-8752
Mailing Address - Country:US
Mailing Address - Phone:360-416-6735
Mailing Address - Fax:360-424-6954
Practice Address - Street 1:2100 LITTLE MOUNTAIN LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8752
Practice Address - Country:US
Practice Address - Phone:360-416-6735
Practice Address - Fax:360-424-6954
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60122633207W00000X
CAA76921207W00000X
IN01066189A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB32883Medicare PIN